November 16, 2009
Vol. II, No. 14
House Reform Bill Supports Medical Home Pilots & Payments
The healthcare reform bill narrowly passed 10 days ago by the House of Representatives would allocate $30 million over five years for pilots of both independent and community-based patient-centered medical home (PCMH) models.
The House bill encourages PCMH pilots "in a variety of settings, including urban, rural, and underserved areas" and rapid deployment of the PCMH on a national basis, particularly for high-risk Medicare beneficiaries. The bill proposes that prospective payments to medical homes be "based on beneficiary risk scores to ensure that higher payments are made for higher-risk beneficiaries." Supported is a prospective monthly fee for each targeted high-need beneficiary in an independent PCMH and two monthly prospective payments in a community-based PCMH (for the community organization and PCP).
The bill encourages participation by physician practices large and small, defines larger PCMH roles for nurse practitioners and physician assistants and advocates the use of evidence-based guidelines in the PCMH. Also supported is a $1.2 billion five-year medical home pilot for Medicaid beneficiaries that encourages the use of technologies like wireless patient monitoring to "enable providers and practitioners to communicate directly with their patients in managing chronic illness."
The PCMH is one of several "innovative payment mechanisms" supported by the House bill, along with "accountable care organizations, value-based purchasing, bundling of services, differential payment rates, performance or utilization based payments, partial capitation and direct contracting with providers."
The passage of the bill is the first of several legislative hurdles on the road to comprehensive healthcare reform.
To read the 1,990-page House bill in its entirety, please visit:
More than 1,000 Michigan providers took advantage of a limited-time offer for free one-year registry licenses, interfaces, implementation support and project management from WellCentive.The WellCentive Registryis a comprehensive, point-of-care, Web-based preventive care and chronic disease management solution, normally costs $550 per provider per year.
The offer had been extended to all providers in Michigan that were not already WellCentive customers. The free registry license program includes an inbound lab results interface with Quest Diagnostics and outbound interfaces to Priority Health and Blue Care Network for pay-for-performance (PFP) reporting. WellCentive’s point-of-care patient registry systems and HIE platforms systems support the PCMH, PFP, CMS PQRI, chronic disease management and other programs.
"While many Michigan providers have been using WellCentive Registry for years, not everyone understands how registries can engage physicians, improve care and cut costs using point-of-care decision support, population-based reporting, and automated patient outreach," said Paul D. Taylor, M.D., WellCentive’s CEO and medical director. “We wanted to encourage physicians and physician organizations that are on the fence, to take the plunge and join the growing clinical quality improvement movement,” said Taylor.
For more information, please visit:
Healthcare reform and the posting of hospital readmission rates for Medicare patients with heart attack, heart failure and pneumonia on the CMS Hospital Compare site and the tying of these rates to reimbursement are making healthcare organizations work harder to keep patients from returning to the hospital. Describe your strategies by taking the HIN 2009 Hospital Readmissions Benchmark Survey and receive an e-summary of the results once the survey is completed.
Complete the survey by visiting
Healthcare Trends Update: Care Transitions Across Sites
Planning for patients' care transitions can have a significant effect on health outcomes, likelihood of readmission and ER visits, utilization cost and the burden on caregivers and family members. This white paper is based on responses from nearly 100 healthcare organizations to HIN’s April 2009 e-survey. Respondents shared their organizations' experiences with care transitions.
To download this complimentary white paper, please visit:
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